Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19.

IF 11.5 1区医学 Q1 DERMATOLOGY JAMA dermatology Pub Date : 2024-11-06 DOI:10.1001/jamadermatol.2024.4233

Yeon-Woo Heo, Jae Joon Jeon, Min Chul Ha, You Hyun Kim, Solam Lee

{"title":"Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19.","authors":"Yeon-Woo Heo, Jae Joon Jeon, Min Chul Ha, You Hyun Kim, Solam Lee","doi":"10.1001/jamadermatol.2024.4233","DOIUrl":null,"url":null,"abstract":"Importance: Few studies have investigated the association between COVID-19 and autoimmune and autoinflammatory connective tissue disorders; however, research with long-term observation remains insufficient.Objective: To investigate the long-term risk of autoimmune and autoinflammatory diseases after COVID-19 over an extended observation period.Design, setting, and participants: This retrospective nationwide population-based study investigated the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service (K-COV-N) cohort. Individuals with confirmed COVID-19 from October 8, 2020, to December 31, 2022, and controls identified among individuals who participated in the general health examination in 2018 were included in the analysis.Exposures: Confirmed COVID-19.Main outcomes and measures: Incidence and risk of autoimmune and autoinflammatory connective tissue disorders in patients after COVID-19. Various covariates, such as demographic characteristics, general health data, socioeconomic status, and comorbidity profiles, were balanced using inverse probability weighting.Results: A total of 6 912 427 participants (53.6% male; mean [SD] age, 53.39 [20.13] years) consisting of 3 145 388 with COVID-19 and 3 767 039 controls with an observational period of more than 180 days were included. Alopecia areata (adjusted hazard ratio [AHR], 1.11 [95% CI, 1.07-1.15]), alopecia totalis (AHR, 1.24 [95% CI, 1.09-1.42]), vitiligo (AHR, 1.11 [95% CI, 1.04-1.19]), Behçet disease (AHR, 1.45 [95% CI, 1.20-1.74]), Crohn disease (AHR, 1.35 [95% CI, 1.14-1.60]), ulcerative colitis (AHR, 1.15 [95% CI, 1.04-1.28]), rheumatoid arthritis (AHR, 1.09 [95% CI, 1.06-1.12]), systemic lupus erythematosus (AHR, 1.14 [95% CI, 1.01-1.28]), Sjögren syndrome (AHR, 1.13 [95% CI, 1.03-1.25]), ankylosing spondylitis (AHR, 1.11 [95% CI, 1.02-1.20]), and bullous pemphigoid (AHR, 1.62 [95% CI, 1.07-2.45]) were associated with higher risk in the COVID-19 group. Subgroup analyses revealed that demographic factors, including male and female sex, age younger than 40 years, and age 40 years and older, exhibited diverse associations with the risk of autoimmune and autoinflammatory outcomes. In addition, severe COVID-19 infection requiring intensive care unit admission, the Delta period, and not being vaccinated were associated with higher risk.Conclusions and relevance: This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks.","PeriodicalId":14734,"journal":{"name":"JAMA dermatology","volume":null,"pages":null},"PeriodicalIF":11.5000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541739/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamadermatol.2024.4233","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Importance: Few studies have investigated the association between COVID-19 and autoimmune and autoinflammatory connective tissue disorders; however, research with long-term observation remains insufficient.

Objective: To investigate the long-term risk of autoimmune and autoinflammatory diseases after COVID-19 over an extended observation period.

Design, setting, and participants: This retrospective nationwide population-based study investigated the Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service (K-COV-N) cohort. Individuals with confirmed COVID-19 from October 8, 2020, to December 31, 2022, and controls identified among individuals who participated in the general health examination in 2018 were included in the analysis.

Exposures: Confirmed COVID-19.

Main outcomes and measures: Incidence and risk of autoimmune and autoinflammatory connective tissue disorders in patients after COVID-19. Various covariates, such as demographic characteristics, general health data, socioeconomic status, and comorbidity profiles, were balanced using inverse probability weighting.

Results: A total of 6 912 427 participants (53.6% male; mean [SD] age, 53.39 [20.13] years) consisting of 3 145 388 with COVID-19 and 3 767 039 controls with an observational period of more than 180 days were included. Alopecia areata (adjusted hazard ratio [AHR], 1.11 [95% CI, 1.07-1.15]), alopecia totalis (AHR, 1.24 [95% CI, 1.09-1.42]), vitiligo (AHR, 1.11 [95% CI, 1.04-1.19]), Behçet disease (AHR, 1.45 [95% CI, 1.20-1.74]), Crohn disease (AHR, 1.35 [95% CI, 1.14-1.60]), ulcerative colitis (AHR, 1.15 [95% CI, 1.04-1.28]), rheumatoid arthritis (AHR, 1.09 [95% CI, 1.06-1.12]), systemic lupus erythematosus (AHR, 1.14 [95% CI, 1.01-1.28]), Sjögren syndrome (AHR, 1.13 [95% CI, 1.03-1.25]), ankylosing spondylitis (AHR, 1.11 [95% CI, 1.02-1.20]), and bullous pemphigoid (AHR, 1.62 [95% CI, 1.07-2.45]) were associated with higher risk in the COVID-19 group. Subgroup analyses revealed that demographic factors, including male and female sex, age younger than 40 years, and age 40 years and older, exhibited diverse associations with the risk of autoimmune and autoinflammatory outcomes. In addition, severe COVID-19 infection requiring intensive care unit admission, the Delta period, and not being vaccinated were associated with higher risk.

Conclusions and relevance: This retrospective cohort study with an extended follow-up period found associations between COVID-19 and the long-term risk of various autoimmune and autoinflammatory connective tissue disorders. Long-term monitoring and care of patients is crucial after COVID-19, considering demographic factors, disease severity, and vaccination status, to mitigate these risks.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

COVID-19 后自身免疫和自身炎症性结缔组织疾病的长期风险。

重要性：很少有研究调查了COVID-19与自身免疫性和自身炎症性结缔组织疾病之间的关联；然而，长期观察的研究仍然不足：调查长期观察 COVID-19 后患自身免疫性疾病和自身炎症性疾病的长期风险：这项以全国人口为基础的回顾性研究调查了韩国疾病预防控制机构-COVID-19-国民健康保险服务（K-COV-N）队列。分析对象包括 2020 年 10 月 8 日至 2022 年 12 月 31 日期间确诊为 COVID-19 的个体，以及在 2018 年参加一般健康检查的个体中确定的对照组：确诊的COVID-19.主要结果和测量指标：COVID-19后患者自身免疫性和自身炎症性结缔组织疾病的发病率和风险。采用反概率加权法平衡人口统计学特征、一般健康数据、社会经济状况和合并症概况等各种协变量：共纳入了 6 912 427 名参与者（53.6% 为男性；平均 [SD] 年龄为 53.39 [20.13] 岁），其中包括 3 145 388 名 COVID-19 患者和 3 767 039 名观察期超过 180 天的对照组患者。其中，斑秃（调整后危险比 [AHR]，1.11 [95% CI，1.07-1.15]）、全秃（AHR，1.24 [95% CI，1.09-1.42]）、白癜风（AHR，1.11 [95% CI，1.04-1.19]）、白塞氏病（AHR，1.45 [95% CI，1.20-1.74]）、克罗恩病（AHR，1.35 [95% CI，1.14-1.60]）、溃疡性结肠炎（AHR，1.15 [95% CI，1.04-1.28]）、类风湿（AHR，1.15 [95% CI，1.04-1.19]）。28]）、类风湿性关节炎（AHR，1.09 [95% CI，1.06-1.12]）、系统性红斑狼疮（AHR，1.14 [95% CI，1.01-1.28]）、Sjögren 综合征（AHR，1.13 [95% CI，1.03-1.25]）、强直性脊柱炎（AHR，1.15 [95% CI，1.04-1.28]）。25]）、强直性脊柱炎（AHR，1.11 [95% CI，1.02-1.20]）和牛皮癣（AHR，1.62 [95% CI，1.07-2.45]）与 COVID-19 组的较高风险相关。亚组分析显示，人口统计学因素（包括男女性别、40 岁以下和 40 岁及以上）与自身免疫和自身炎症结果的风险呈现出不同的关联。此外，需要入住重症监护室的严重COVID-19感染、德尔塔时期和未接种疫苗与较高风险相关：这项延长随访期的回顾性队列研究发现，COVID-19 与各种自身免疫性和自身炎症性结缔组织疾病的长期风险有关。考虑到人口统计学因素、疾病严重程度和疫苗接种情况，在 COVID-19 后对患者进行长期监测和护理对降低这些风险至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

JAMA dermatology DERMATOLOGY-

CiteScore

14.10

自引率

5.50%

发文量

300

期刊介绍： JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists. JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.

期刊最新文献

COVID-19 as a Risk Factor For Autoimmune Skin Disease. Long-Term Risk of Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19. Madelung Disease. Psoriasis Risk With Immune Checkpoint Inhibitors. Use of Anti-PD1 Blockade After Hedgehog Inhibitors or as First-Line Therapy for Gorlin Syndrome.